Rumbling in the house of health

UNLESS the brewing tension in the health sector is doused urgently, it may soon snowball into a crisis that will paralyse that industry nationwide.

The crisis may be triggered by the grouse of health workers, excluding medical doctors, under the aegis of the Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professional Association (AHPA) that they have been denied appointments to some key positions.

The Guardian’s investigation reveals that all the major positions in the sector including those of the minister, minister of state for health, permanent secretary of the Federal Ministry of Health (FMOH) and the minister of Labour and Productivity are all occupied by medical doctors.

Health workers had petitioned President Muhammadu Buhari over lop-sided appointments in the FMoH even as they among other things, asked for an urgent review to ensure equity and balance in appointments in the interest of peace.

But medical doctors across the country have continued to applaud Buhari for the appointments with immediate past president of the Nigerian Medical Association (NMA) and Vice President (African Region) of the Commonwealth Medical Association (CMA), Dr. Osahon Enabulele, praising Buhari for appointing competent professionals as ministers to oversee the health ministry.

Enabulele said the appointment of Prof. Isaac Adewole and Dr. Osagie Ehanire as Minister of Health and Minister of State for Health respectively would give the sector a new lease of life.

But health workers, in a letter to Buhari jointly signed by Chairman JOHESU, Jay Josiah, and Chairman APHA, Dr. Godswill C. Okara, titled “Appraising Appointments in the Federal Ministry of Health” noted: “While Nigeria appears to be on course for a great future, we are worried that the ever-boiling health sector appears to be headed for more heated discourse especially against the background of recent appointments in the leadership strata of the Federal Ministry of Health.

“Your Excellency, the appointment of two medical doctors as ministers in charge of the Federal Ministry of Health equaled the precedent set by former President Goodluck Jonathan, GCFR, which unfortunately catalysed unprecedented dislocation of the component elements of the health sector in that dispensation.

“The only ameliorating balm in that discourse was that the permanent secretaries in the Federal Ministry of Health were always administrators or non-care providers. Today, even that has been taken away because the new permanent secretary is also a traditional, strong advocate of the interests of only her medical doctor colleagues from her time as a permanent secretary in the Office of the Head of Service of the Federation.

“To compound the woes of all other health workers apart from doctors whom we represent, the Federal Ministry of Labour and Productivity which ordinarily should arbitrate over our welfare demands which the hegemony of doctors’ over-bearing leadership truncates at the Federal Ministry of Health is now being headed by yet another medical doctor, Dr. Chris Ngige.

“For a health sector where doctors hitherto reduced a supposed Federal Ministry of Health to a ‘Ministry of Doctors’ to now be officially legitimised as home to only doctors who constitute less than 5% of the workforce at the detriment of the majority of over 95% in our humble opinion Your Excellency, appears to epitomise neglect of the feelings of the greater majority of health workers and will aggravate the volatility in the sector instead of abating it.”

The health workers alleged that the NMA was already reaping the expected fruits of the benevolent appointments. They wrote: “On Friday, November 13, 2015, the Hon. Minister of Health, Prof. Issac Adewole visited the NMA Secretariat in Abuja where he met both the Nigeria Medical Association President, Dr. Kayode Obembe and National Association of Resident Doctors (NARD) President, Dr. Muhammed Askira.”

JOHESU and AHPA alleged that the minister was reported to have assured his colleagues to be patient as he would actualise their demands which include : preservation of the status quo ante in appointments to boards of the 55 federal health institutions; implementing the Yayale Ahmed Panel report, which only favours the NMA in the health sector and this, at a time other health workers are challenging and infact seeking to quash the report at the National Industrial Court of Nigeria (NICN). “Today, we are aware the Health Minister and Labour Minister are raising legal teams to join forces against us at the NICN,” they said.

The aggrieved workers also faulted alleged plans to implement the agenda of the NMA through the National Health Act; setting up committees made up exclusively of doctors as usual imposing relativity for doctors in the federal health institutions even when other health professionals who got NICN judgments in their favour since 2010 have not been paid by some chief medical directors (CMDs); exclusive overseas training for medical doctors through improved residency programmes and designing of new welfare schemes for National Youth Service Corps doctors among other contentious issues.

The health workers said having evaluated the situation in the last few days, it was only in tandem with commonsense that they respectfully request Buhari to look into their prayers, which include: an urgent need to balance the various appointments already made at the Federal Ministry of Health in the interest of enduring peace in the health sector; “a dire need to appoint healthcare providers of diverse backgrounds within the rank and file of our members as special adviser on health to the president, senior special assistant on health in addition to lawful appointments of our members who should head some of the key parastatals in the health sector based on existing condition precedents in the relevant statutes,” among other demands.

“As citizens of this country, we are fed up with a status-quo that continually consumes and diminishes our potential because our commonwealth is always being poached while our privileges as citizens are breached as well as trampled upon.

“We are of the firm opinion that as Your Excellency builds structures to preserve our national heritage, the collective destinies of all shades with tendencies of our people must be reckoned with. This cannot be said to be a reality in the health sector where it continues to be convenient to sacrifice the destiny of 95 per cent of the workforce for the pecuniary interests of a few sacred cows,” they said.